Magnetic coupling is one of the few physical phenomena capable of transmitting motion across a physical barrier. In gastrointestinal endoscopy, remote magnetic manipulation has the potential to make screening less invasive and more acceptable, thus saving lives by early diagnoses and treatment. Closed-loop control of the magnetic device position is crucial for a safe and reliable operation. In order to implement closed-loop control, the pose (position and orientation) of the device must be available in real-time. This becomes challenging if magnetic coupling is achieved by permanent magnets, since the strong magnetic field required for manipulation interferes with current localization techniques. In this work, we present a novel real-time pose detection strategy that is compatible with magnetic manipulation based on permanent magnets. The localization algorithm combines multiple sensor readings with a pre-calculated magnetic field map. The proposed approach is able to provide an average error below 5 mm in position detection, and below 19° for angular motion within a spherical workspace of 15 cm in radius.

Summary: Wearable devices are fast evolving to address mobility and autonomy needs of elderly people who would benefit from physical assistance. Recent developments in soft robotics provide important opportunities to develop soft exoskeletons (also called exosuits) to enable both physical assistance and improved usability and acceptance for users. The XoSoft EU project has developed a modular soft lower limb exoskeleton to assist people with low mobility impairments. In this paper, we present the design of a soft modular lower limb exoskeleton to improve person’s mobility, contributing to independence and enhancing quality of life. The novelty of this work is the integration of quasi-passive elements in a soft exoskeleton. The exoskeleton provides mechanical assistance for subjects with low mobility impairments reducing energy requirements between 10% and 20%. Investigation of different control strategies based on gait segmentation and actuation elements is presented. A first hip–knee unilateral prototype is described, developed, and its performance assessed on a post-stroke patient for straight walking. The study presents an analysis of the human–exoskeleton energy patterns by way of the task-based biological power generation. The resultant assistance, in terms of power, was 10.9% ± 2.2% for hip actuation and 9.3% ± 3.5% for knee actuation. The control strategy improved the gait and postural patterns by increasing joint angles and foot clearance at specific phases of the walking cycle.

The purpose of this study is to validate a Jacobian-based iterative method for real-time localization of magnetically controlled endoscopic capsules. The proposed approach applies finite-element solutions to the magnetic field problem and least-squares interpolations to obtain closed-form and fast estimates of the magnetic field. By defining a closed-form expression for the Jacobian of the magnetic field relative to changes in the capsule pose, we are able to obtain an iterative localization at a faster computational time when compared with prior works, without suffering from the inaccuracies stemming from dipole assumptions. This new algorithm can be used in conjunction with an absolute localization technique that provides initialization values at a slower refresh rate. The proposed approach was assessed via simulation and experimental trials, adopting a wireless capsule equipped with a permanent magnet, six magnetic field sensors, and an inertial measurement unit. The overall refresh rate, including sensor data acquisition and wireless communication was 7 ms, thus enabling closed-loop control strategies for magnetic manipulation running faster than 100 Hz. The average localization error, expressed in cylindrical coordinates was below 7 mm in both the radial and axial components and 5$^\circ$ in the azimuthal component. The average error for the capsule orientation angles, obtained by fusing gyroscope and inclinometer measurements, was below 5$^\circ$.

Occupational back-support exoskeletons are becoming a more and more common solution to mitigate work-related lower-back pain associated with lifting activities. In addition to lifting, there are many other tasks performed by workers, such as carrying, pushing, and pulling, that might benefit from the use of an exoskeleton. In this work, the impact that carrying has on lower-back loading compared to lifting and the need to select different assistive strategies based on the performed task are presented. This latter need is studied by using a control strategy that commands for constant torques. The results of the experimental campaign conducted on 9 subjects suggest that such a control strategy is beneficial for the back muscles (up to 12% reduction in overall lumbar activity), but constrains the legs (around 10% reduction in hip and knee ranges of motion). Task recognition and the design of specific controllers can be exploited by active and, partially, passive exoskeletons to enhance their versatility, i.e., the ability to adapt to different requirements.

In an open surgery, identification of precise margins for curative tissue resection is performed by manual palpation. This is not the case for minimally invasive and robotic procedures, where tactile feedback is either distorted or not available. In this paper, we introduce the concept of intraoperative wireless tissue palpation. The wireless palpation probe (WPP) is a cylindrical device (15 mm in diameter, 60 mm in length) that can be deployed through a trocar incision and directly controlled by the surgeon to create a volumetric stiffness distribution map of the region of interest. This map can then be used to guide the tissue resection to minimize healthy tissue loss. The wireless operation prevents the need for a dedicated port and reduces the chance of instrument clashing in the operating field. The WPP is able to measure in real time the indentation pressure with a sensitivity of 34 Pa, the indentation depth with an accuracy of 0.68 mm, and the probe position with a maximum error of 11.3 mm in a tridimensional workspace. The WPP was assessed on the benchtop in detecting the local stiffness of two different silicone tissue simulators (elastic modulus ranging from 45 to 220 kPa), showing a maximum relative error below 5%. Then, in vivo trials were aimed to identify an agar-gel lump injected into a porcine liver and to assess the device usability within the frame of a laparoscopic procedure. The stiffness map created intraoperatively by the WPP was compared with a map generated ex vivo by a standard uniaxial material tester, showing less than 8% local stiffness error at the site of the lump.

There is a growing international interest in developing soft wearable robotic devices to improve mobility and daily life autonomy as well as for rehabilitation purposes. Usability, comfort and acceptance of such devices will affect their uptakes in mainstream daily life. The XoSoft EU project developed a modular soft lower-limb exoskeleton to assist people with low mobility impairments. This paper presents the bio-inspired design of a soft, modular exoskeleton for lower limb assistance based on pneumatic quasi-passive actuation. The design of a modular reconfigurable prototype and its performance are presented. This actuation centers on an active mechanical element to modulate the assistance generated by a traditional passive component, in this case an elastic belt. This study assesses the feasibility of this type of assistive device by evaluating the energetic outcomes on a healthy subject during a walking task. Human-exoskeleton interaction in relation to task-based biological power assistance and kinematics variations of the gait are evaluated. The resultant assistance, in terms of overall power ratio (Λ) between the exoskeleton and the assisted joint, was 26.6% for hip actuation, 9.3% for the knee and 12.6% for the ankle. The released maximum power supplied on each articulation, was 113.6% for the hip, 93.2% for the knee, and 150.8% for the ankle.